NHS England suggests GPs are failing to deliver 'appropriate level of activity'

GP leaders have hit out at an NHS England report that says work is ongoing to 'restore primary care services to appropriate levels of activity' - just weeks after its top GP apologised over 'insulting' claims that practices were failing to offer patients face-to-face appointments.

(Photo: SOPA Images/Getty Images)
(Photo: SOPA Images/Getty Images)

An NHS England board paper published on 1 October says: ‘Work is continuing to recover and restore primary care services to appropriate levels of activity including getting the balance right between phone/online and face-to-face appointments (which are running at around one third to one half of the total).'

RCGP chair Professor Martin Marshall said any suggestion that GP practices had not delivered appropriate levels of work at any stage during the pandemic was simply 'wrong'.

The board paper comes just a fortnight after NHS England's primary care medical director Dr Nikki Kanani apologised after officials triggered a wave of negative media coverage with a letter to GPs warning them that failure to offer face-to-face appointments could be a breach of contract.

GP workload

The letter sparked outrage among GPs, who called it an 'insult' to the profession at a time when workload is soaring. GPonline reported this week that four in five GPs are currently reporting workload levels that are above normal - while practices delivered a huge increase in face-to-face appointments at the beginning of September.

Responding to the board paper, Professor Marshall, said: ‘If NHS England are suggesting that general practice has not been operating at an "appropriate" level, at any stage, during the pandemic then they are wrong.

‘GPs and their teams have worked hard throughout, ensuring that hospitals did not become overwhelmed, delivering the vast majority of patient care in the NHS, all with the prospect of an exceptionally difficult winter ahead.’

Professor Marshall pointed out that practices had remained open through the pandemic, and shifted to delivering a predominantly remote service 'to comply with official government guidance' as the NHS sought to stop the spread of COVID-19.

GP appointments

He pointed out that data from both the RCGP and the NHS show routine GP appointments are around normal levels for this time of year.

BMA GP committee chair Dr Richard Vautrey, said: ‘The latest data has shown a significant rise in face-to-face appointments in recent weeks, and NHSE/I would do well to recognise the lengths practices are already going to in meeting this demand, and provide them with proper support.

‘Practices are extremely concerned with the rising cases of COVID nationally, and are worried about how they will be able to manage to protect their staff and patients, and continue to provide services, if there is another peak this winter. This is why the BMA is calling for not just understanding, but urgent support measures, to be put in place to help practices cope in the coming months.’

Rising demand for appointments in general practice comes as practices have started work on an expanded flu campaign for 2020/21, which could see vaccinations delivered to half the UK population - while targets linked to three primary care network (PCN) service specifications took effect this month.

NHS morale

BMA leaders said the letter on face-to-face appointments had led to a large number of practices receiving complaints, while some staff were verbally abused - calling it ‘another major hammer blow' to morale.

Professor Marshall called on NHS England to step up support for general practice. 'Prior to the COVID pandemic, the college worked to address the unsustainable workload pressures and workforce issues general practice was facing – and the knock-on effect on patients and the wider NHS,' he said.

‘We need NHS England to ensure resources and workforce are sufficient and readily available in order to meet patient demand. As we head into winter I can’t stress enough that the pending workload that GPs are set to tackle must not be underestimated,’ he added.

In her apology for the letter last month, Dr Kanani said: 'I am so proud of the way general practice responded to the pandemic, safely assessing, speaking to and seeing patients as clinically needed. Any conclusions drawn by the media about my colleagues are not mine, and I apologise for any hurt caused.

‘As you know the changes in our ways of working have made it even more important that we are clear with patients about how best to use our services, and that WE ARE OPEN.’

‘The pandemic continues to be very difficult for both our patients and practices and I’m grateful for the incredible work done by primary care throughout.'

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